Efficacy of intraligamentary anesthesia in maxillary first molar extraction

Soukaina Tawfiq Ryalat,1 Mohammad H Al-Shayyab,1 Wala Amin,2 Saif Aldeen AlRyalat,3 Nosaiba Al-Ryalat,4 Faleh Sawair1 1Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Jordan, Amman, Jordan; 2Department of Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan; 3Department of Ophthalmology, Faculty of Medicine, University of Jordan, Amman, Jordan; 4Department of Radiology and Nuclear Medicine, University of Jordan, Amman, Jordan Introduction: Infiltration anesthesia (IA) is the method to anaesthetize maxillary teeth successfully. In contrast, intraligamentary anesthesia (ILA) has been used as supplementary anesthesia during tooth extraction, particularly when regional block anesthesia has failed. In this study, we compare the efficacy of and patient satisfaction with ILA vs IA when extracting maxillary first molar teeth. Methods: Forty patients were enrolled in this study and 80 maxillary first molars extracted. All patients served as their own control, with ILA as the experimental side and IA as the control side. The two techniques were compared for efficacy using a visual analog scale (VAS) and patient satisfaction compared using a verbal rating scale (VRS). Results: The mean VAS pain score for extraction using ILA was lower than that for IA (20.30±3.18 and 13.93±1.95 mm, respectively; P<0.001). For injection pain, the mean VAS pain score in the ILA side was higher than the IA side (42.28±4.51 and 31.73±3.1 mm, respectively; P<0.001). VRS results showed a higher number of patients who felt that pain during ILA was greater than expected compared with IA. Conclusion: IA appears less painful during injection compared with ILA, and provides sufficient pain relief during extraction. However, ILA can be used when IA fails to achieve the desired pain suppression, as it provides higher extraction-pain relief. Keywords: infiltration anesthesia, maxillary first molars, intraligamentary anesthesia, periodontal intraligamentary anesthesi